AIDS: Genesis and Resolution

by John Lange, M.D.
Scientific Symposium I 1988

Prologue

In The Urantia Book the Life Carrier states, "But throughout
all of this biologic adventure our greatest disappointment grew out of
the reversion of certain primitive plant life to the prechlorophyll levels
of parasitic bacteria on such an extensive and unexpected scale. This eventuality
in plant-life evolution caused many distressful diseases in the higher
mammals, particularly in the more vulnerable human species." (*736)
To portray the relevance of this event to late twentieth-century society,
I have chosen to discuss the acquired immune deficiency syndrome. The advent
of nuclear weapons has permanently altered man's confrontational limits.
Similarly, the AIDS virus changed the rules of intimate contact forever.
Society is visibly shaken by these events, because working with mind alone,
without spirit, our fear of self-destruction is ever greater than our hope
of self-preservation and survival. As a student of The Urantia Book
and a physician, I will draw on its teachings and attempt to answer two
questions central to the AIDS issue. What is the genesis of the epidemic?
And what is a path to resolution?

Introduction

AIDS is caused by a retrovirus, commonly known as HIV (the human immune
deficiency virus). Viruses are particles with biologic potential containing
only an outer protein coat and an inner core of genetic material, either
DNA or RNA. This genetic material must gain access to the nucleus of the
cell and integrate itself into the host genetic material. It then directs
the cellular machinery toward its own replication and transmission. HIV
contains only RNA, and thus must be converted back into DNA before it can
be integrated into the host genetic core structure. This is accomplished
by an unusual enzyme known as reverse transcriptase (RTase).

Prior to 1975, scientists supported the Central Dogma of Crick put forth
by Dr. Francis Crick (of Watson and Crick fame who discovered the double
helix structure of DNA). Simply stated, the DNA code functioned as a one-way
street. DNA was translated into RNA, which then coded for specific proteins
resulting in biologic activity. In 1975 Dr. David Baltimore put this theory
to rest by discovering this enzyme, reverse transcriptase, which would
turn RNA back into DNA (Figure 1).

Once HIV has infected the human host, it attaches to a specific receptor
on the cell membrane of its target cell, the T4 lymphocyte. The virus then
uncoats its protein covering. Its genetic material, RNA, then enters the
cellular cytoplasm and by employing RTase is reverse transcribed to DNA.
This proviral DNA is then integrated into the host cellular DNA. A cellular
event then triggers the viral DNA replication to mRNA, the production of
proteins, and the eventual assembly into a mature virus. Multiple viral
particles then bud from the cell surface, and cell death then ensues.

The origin of HIV is obscure. Some believe it was transmitted by the
African green monkeys, while others think its structure is too dissimilar
to cross the species barrier. Most likely it has been associated with man
for a long time, and more recently has been recognized to cause disease
states.

HIV is transmitted through blood, sex and birth. Casual contact is virtually
impossible. People are encouraged to avoid any exchange of bodily secretions,
but tears and saliva have a very low if not negligible risk. Safe sex is
encouraged, but there is no such thing as safe sex. There is safer sex.
Our blood supply is now safe, but only after 50% of the hemophiliacs have
been infected. The risk of infection with birth is 60%, with a needle stick
1%, and with a blood transfusion 95%. The risk of one sexual encounter
is unknown, but the pattern is one of multiple exposures over a period
of time.

The T4 lymphocyte orchestrates the human immune response. As T4 cell
death increases, a global immunologic defect ensues. This may take from
2 to 8 years. AIDS is often preceded by AIDS Related Complex (ARC). This
is characterized by weight loss, night sweats, fever, diarrhea, and lymphadenopathy.
AIDS is then diagnosed with the appearance of Kaposi's sarcoma and/or opportunistic
infections, e.g., pneumocyctis pneumonia. There is no known cure, and many
believe the vast majority of those infected will eventually be diagnosed
with AIDS (Figure 2).

There are estimated to be 1.0 to 1.5 million Americans infected with
HIV. 50,000 cases have been reported and one-half of these are dead. It
is estimated that by 1991, 250,000 people in the U.S. will have suffered
the mortal effects of the disease.

Epidemiology

The AIDS epidemic is distinctive from other pandemics of the Western
world in that it has been initiated by ideology and consolidated by social
patterns. By contrast the bubonic plague was initiated by exploration and
consolidated by commerce; and tuberculosis by industrialization and urbanization,
respectively. Comparison will explain why the spread of AIDS is more closely
related to the spread of TB than the bubonic plague (Figure 3).

There are two major patterns and a third emerging pattern of epidemic
spread by AIDS in the world. Pattern #1 involves Western Europe, North
America, some areas in South America, Australia, and New Zealand. Homosexual/bisexual
men and intravenous drug abusers are the major affected groups. Pattern
#2 involves Africa, the Caribbean, and some areas in South America. Heterosexuals
are the main population group affected. Pattern #3 began to emerge in the
mid-1980s and involves Asia, part of the Pacific region, the Middle East,
Eastern Europe, and some rural areas of South America. Both homosexual
and heterosexual transmission is just being documented. Little information
is available concerning the Soviet Union, but some speculate military adventurism
in many epidemic areas has led to increased infection rates at home.

Pattern #2 resulted from policies of post-colonial African nations,
which led to desertification of the Sahal and the massive influx of refugees
to urban centers. The Sahal can support only a limited pastoral population
where the nomads lived in balance with the land on marginal resources.
Policies of the new African nations constructed the nomads, and the land
was quickly exhausted. These people moved to the cities in search of a
livelihood. The combination of unemployment, prostitution, and chronic
disease in central African urban centers fueled the AIDS epidemic.

Pattern #1 resulted from a mixed acceptance of the gay population and
the subsequent gathering in urban enclaves for group identity. The Gay
Movement took shape in the late 1960s encouraged by a more permissive society
and by a growing notion in the scientific community that homosexual behavior
is biologically based. A societal evolutionary growth process which should
have taken much longer and should have included obligations along with
freedoms was attempted overnight. Thus, self-restraint gave way to self-expression,
and into this milieu of overrapid growth the AIDS virus was introduced
and flourished. Therefore, AIDS is presented as two distinct focal expressions
arising from similar underlying social patterns (Figure 4).

Resolution

At present the prospects for a cure or a successful vaccine are concealed
beyond the horizon. The virus changes its spots too rapidly for a conventional
vaccine. (This is not new, because vaccines to malaria and schistosomiasis
have been unsuccessful.)

Patient trials have thus far failed to develop immunity. AIDS treatment
currently focuses on the resulting opportunistic infections with antibiotics.
An anti-retroviral agent, azidothymidine (known as AZT and blocks RTase),
is given with some success to those with AIDS and more recently to those
found to be HIV positive. Other antiviral mechanisms are being investigated,
e.g., an oligonucleotide probe to trick the virus into producing an inactive
offspring.

Immune modulation is an area holding great promise. In a small clinical
trial, methionine-enkephalin (an endorphin) has been administered showing
enhanced immunity. For those HIV positive, immune enhancement is encouraged
with stress reduction, nutrition, and exercise. Today we stand at the limits
of our medical vision offering the same advice to one infected with HIV
we gave to a patient infected with TB in 1900. A true cure awaits major
breakthroughs in knowledge about viral behavior and immunology.

The victory over AIDS will be through efforts at containment and prevention
rather than a specific scientific or clinical thrust. Resolution can be
gained by drawing on two archetypal experiences in our national consciousness.
First, the medical community must shed the illusion this disease resembles
the bubonic plague. Similar characteristics of epidemiology and infection
make tuberculosis a more appropriate model for disease control. TB became
widespread with industrialization and urbanization, and it was controlled
by public health measures and suburbanization. Likewise, AIDS was encouraged
by a more permissive society and then grew within the resulting new social
patterns. And AIDS will be controlled through education, monogamy, and
community assimilation. Of note, TB is a disease whose medical treatment
has grown to maturity, and its persistence in the world is now a direct
result of social factors. Similarly, even if a cure for AIDS were discovered
tomorrow, the social patterns supporting the epidemic would render efforts
at control disappointing.

Second, our social scientists should recognize uncontrolled promiscuity
and IV drug abuse as addictive behavior, and should look to our experience
with alcoholism through Alcoholics Anonymous as a model for individual
and group rehabilitation. To my mind, the secular religious approach in
AA is the most powerful path to transformation in our society today. In
essence, the thrust should move beyond clean needles and safe sex toward
a higher spiritual meaning for one's life. Because, just like the alcoholic,
the risk for AIDS is also life long (Figure 5).

The Future

Understanding and analysis reach an end point when one looks upon the
children afflicted with AIDS. Helpless to their fate, they are being left
orphaned and unloved to die alone in hospital isolation beds. And one is
tempted to believe those involved have been forsaken in the scheme of cosmic
overcontrol. I am reminded of the words of a Mighty Messenger explaining
the Lucifer Rebellion, "We cannot fathom the wisdom which allows such
catastrophes." And the Melchizedeks now teach that the good coming
from the Satania Rebellion now outnumbers the sum total of evil by a factor
of one thousand. From the wisdom of this cosmic holocaust we should take
a broader perspective. Realize that not only will the AIDS epidemic serve
as a vehicle for social change, but it will also amplify the spiritual
quality of planetary evolution. It will serve to unify and further the
evolution of medicine, ethics, and religion. In medicine, the AIDS virus
will serve as a biologic probe and take us from an organ system approach
through advances in immunology to a holistic and environmental approach.
In ethics, a realization of group needs will move us from beneficence and
respect for autonomy through solidarity and mutuality to a Jesusonian sense
of community. Religion will unify medicine and ethics as the focus shifts
from personal ministry toward totality attitudes and an understanding of
Trinity function (Figure 6).

Epilogue

The perfection process of evolution is an interplay between two forces:
the personal (human free will) and the prepersonal (the AIDS epidemic).
This disappointment of the Life Carriers has again echoed in our time posing
a question. Ascending mortals must furnish a moral answer, as individuals
with self-restraint and as a society with a larger sense of community.
If not, then the answer will be left to the most primordial forces of nature
in time of unchecked will and appetite.